Enforcement guidance

The Health and Care Act 2022 (“The Act”) came into effect on 1 July 2022. During 2022/23 we will update this enforcement guidance to reflect the new legislative context.

Until this guidance is updated, we will continue to have regard to this version should it become necessary to consider taking enforcement action against licensed providers of NHS services. Licensed providers are NHS foundation trusts, certain independent providers, and licensed NHS-controlled providers.

NHS trusts have not previously been required to hold a licence, but this will become a requirement under the Act. Until NHS Trusts are licenced, we will support, oversee and direct NHS trusts per our general statutory functions, formerly exercised by the NHS Trust Development Authority. In doing so, we will apply the principles and procedures of this guidance wherever appropriate as a continuation of our long-standing aim of parity between NHS trusts and NHS foundation trusts.

From 1 July 2022, this guidance should be interpreted considering the changed legal framework of the Act and applied in the context of prevailing regulatory practice. This means that:

  • references to Monitor should be read as references to NHS England (as Monitor will be abolished and its functions transferred to NHS England).
  • references to clinical commissioning groups (CCGs) should be read as references to integrated care boards (ICBs) as appropriate (CCGs were replaced on 1st July 2022 and their functions transferred to ICBs).
  • the competition sections of this guidance will no longer apply as the Act repeals Monitor’s statutory competition functions.
  • if there is any inconsistency between legislation and this guidance, the legislation will have primacy.

You can read and download the enforcement guidance here.

Learn more about integrated care here.